• Journal of Korean Medicine Rehabilitation
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• v.24 no.4
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• pp.195-201
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• 2014

The objective of this study is to report the improvement of one patient with physical sequelas induced by spinal epidural abscess surgery. The patient was treated by acupuncture therapy with pulsed electromagnetic therapy and herb medicine. We evaluated the effectiveness by numerical rating scale (NRS). As a result, the patient improved significantly NRS score. And the patient's symptoms were alleviated. We guess that the causes of the patient symptoms are chronic inflammation and fibrosis of dural. We conclude that acupuncture therapy with pulsed electromagnetic therapy is an effective treatment to reduce the residual pain after spinal epidural abscess surgery. But there is a limit on this study due to sufficient number of case. Further studies will be needed.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.392-395
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• 2011

Idiopathic hypertrophic spinal pachymeningitis (IHSP) is a rare inflammatory disease characterized by hypertrophic inflammation of the dura mater and various clinical courses that are from myelopathy. Although many associated diseases have been suggested, the etiology of IHSP is not well understood. The ideal treatment is controversial. In the first case, a 55-year-old woman presented back pain, progressive paraparesis, both leg numbness, and voiding difficulty. Initial magnetic resonance imaging (MRI) demonstrated an anterior epidural mass lesion involving from C6 to mid-thoracic spine area with low signal intensity on T1 and T2 weighted images. We performed decompressive laminectomy and lesional biopsy. After operation, she was subsequently treated with steroid and could walk unaided. In the second case, a 45-year-old woman presented with fever and quadriplegia after a spine fusion operation due to lumbar spinal stenosis and degenerative herniated lumbar disc. Initial MRI showed anterior and posterior epidural mass lesion from foramen magnum to C4 level. She underwent decompressive laminectomy and durotomy followed by steroid therapy. However, her conditions deteriorated gradually and medical complications occurred. In our cases, etiology was not found despite through investigations. Initial MRI showed dural thickening with mixed signal intensity on T1- and T2-weighted images. Pathologic examination revealed chronic nonspecific inflammation in both patients. Although one patient developed several complications, the other showed slow improvement of neurological symptoms with decompressive surgery and steroid therapy. In case of chronic compressive myelopathy due to the dural hypertrophic change, decompressive surgery such as laminectomy or laminoplasty may be helpful as well as postoperative steroid therapy.